• 간호행정학회지
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• 제22권4호
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• pp.396-405
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• 2016

Purpose: The study was done to investigate nurses' customer orientation, emotional labor, unit manager-nurse exchange and relational bonds and to identify the factors affecting nurses' turnover intentions. Methods: A cross-sectional survey was conducted using self-report questionnaires. The participants in this study were 276 nurses in tertiary hospital located in a metropolitan city, Korea. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient and stepwise multiple regression with the SPSS program 22.0. Results: The mean scores were $3.74{\pm}0.90$ (out of 5) for turnover intention, $5.31{\pm}0.87$ (out of 7) for customer orientation, $4.82{\pm}0.96$ (out of 7) for emotional labor, $3.58{\pm}0.61$ (out of 7) for relational bonds, and $3.18{\pm}0.57$ (out of 5) for unit manager-nurse exchange. Factors influencing turnover intention were 'emotional labor' (${\beta}$=.39, p<.001), 'unit manager-nurse exchange' (${\beta}$=-.22, p<.001), 'financial bonds' (${\beta}$=-.19, p<.001), 'perceived economic status' (${\beta}$=-.15 p=.003) and 'career' (${\beta}$=.14, p=.005). These factors explained 34.9% of the variance in turnover intension (F=30.46, p<.001). Conclusion: Findings indicate that to reduce nurses' turnover intention in the hospital, there is a need to improve unit manager-nurse exchange and to manage strategies lowering nurses' emotional labor.

• 간호행정학회지
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• 제10권3호
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• pp.375-386
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• 2004

The purpose of this study was to identify the present use of caregiver services, to evaluate the degree of satisfaction with the services according to type of caregiver service, private or public, and to provide data for the development of a plan which will provide good quality service with less economic and psychological burden to the patients and their families. Survey data were collected from 130 patients in 4 general hospitals in Seoul, and their families. Data were collected during April, 2004, using a questionnaire which included the patient satisfaction scale developed by Jun (2001). Data were analyzed using frequencies, percentages, means and standard deviations, $X^2$ analysis, t-test. The SPSS computer program was used to facilitate analysis. The results of this study are summarized as follows; The total score for satisfaction was high for both groups. For the private caregiver group it was $52.38{\pm}11.08$, and for the public caregiver group, $58.14{\pm}9.64$. This difference was significant(t=-3.391, p=.001). In all of areas, the scores for satisfaction of the public caregiver service group were higher than private caregiver service group, ie. caregivers' attitude, role, confidence, performance, and service charge, and all the differences were significant. In conclusion, it was found that long-term hospitalization of older patients with high dependence resulted in more caregiver service. There were more severe patients in the public caregiver group, but the service charges, additional costs and paid holidays were less. Based on these results, patients and their families were significantly more satisfied with public caregiver service because it was not only less expensive but also had a high quality of service. Thus, caregiver services should be systemized so that patients and their families will get the best quality caregiver service

• 간호행정학회지
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• 제10권4호
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• pp.449-457
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• 2004

Purpose: This study seeks to identify situations where nurses are required to consider alternatives, for the delivery of nursing care, appropriate to the needs of a medical care unit, surgical care unit, and intensive care unit in a university hospital. Method: Data was collected from 100 nurses using an open questionnaire, during a one week period in May, 2003. These nurses all had at least two years of experience within a medical care unit, surgical care unit, or intensive care unit at a university hospital. Results: The situations that nurses typically faced were categorized into 21 problems for nurses including : respiratory problems(26.8%), pain(23.6%), problems in relation to bowel habit(23.2%). In cases where nurses were faced with making decisions in relation to solving respiratory problems, the alternatives included ; applying oxygen(29.3%), physical assessment and monitoring(14.7%), refining and modifying order and suggestion order(9.3%). Ventilator care(9.3%), was chosen to solve pain problems ; doing pm orders(30.3%), placebo medication(27.3%), and to refine and modify orders and suggestions(18.2%). To solve problems in relation to bowel habits ; enemas accounted for 32.3%, and laxative medication 30.8%. Conclusion: To improve the quality of nursing, the outcome of nursing care associated with 21 problems for nurses including : respiratory problems, pain, and problems in relation to bowel habit, should be identified and the best alternative nursing care should be developed.

• 간호행정학회지
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• 제15권1호
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• pp.45-53
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• 2009

Purpose: This study was to analyze the relationship between head nurse's leadership, staff nurse's health promotion life style and job satisfaction and nursing work performance. Method: The duration for investigation took place from September 11 to 29, 2006 and 501 staff nurses. Results: Nursing work performance of 3 groups of nurses that group of nurses who evaluated leadership of head nurse is high in authority aspect but is low in harmony aspect(p<.05), group of nurses who evaluated leadership of head nurse is low in authority aspect but is high in harmony aspect(p<.01), and group of nurses who evaluated leadership of head nurse is high both in authority aspect and in harmony aspect(p<.001), was all statistically much higher than group of nurses who evaluated leadership of head nurse is low both in authority aspect and in harmony aspect. Conclusion: nursing work performance of staff nurses are compositively affected by social psychological factor such as job factor, health promotion conduct, and job satisfaction and leadership factor of head nurse.

• 보건행정학회지
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• 제20권4호
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• pp.97-113
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• 2010

The purpose of this study was to analyze the relationship between the locational characteristics of areas surrounding oriental medicine hospitals and the number of patients who visited study hospitals. Administrative data collected from the annual report of 5 ward offices in Daejeon used to assess the geographical attributes. Two oriental medicine hospitals operated in Daejeon provided data for the number of inpatient and outpatient. Number of patients who visited study hospitals was calculated in each Dong which is the smallest administrative district. The geographical attributes of Daejeon were evaluated by the demographic and economic factors which were assumed to influence the health care demand. Each criterion was measured from each Dong. Weights of factors was calculated by Analytic Hierarchy Process (AHP) method. Evaluation scores which representing the geographical attributes of Dong was computed by multiplying the eight factors and weights. Results showed positive correlation coefficients between the evaluation scores of Dong and the number of patients. One hospital which was more closely located to areas with high evaluation scores had higher number of patients than that of the other hospital. Buffering analysis with varying size support the analysis results. This finding proposed the importance of location for the management of oriental medicine hospitals in a metropolitan city. Applying study model to other cities will enhance the validity of study results.

• 보건행정학회지
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• 제22권4호
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• pp.597-627
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• 2012

As misalignments among images, identity, and legitimacy of health professionals and institutions have been on the rise, CEOs of health care organizations have been required to enhance organizational accountability. Despite the accumulation of literature on the conceptual discussions of accountability, only a few studies empirically investigated key barriers to accountability and its facilitators. To identify perception on accountability with key barriers and facilitators of organizational accountability, a semi-structured interview with 11 CEOs of Korean hospitals was conducted. A short survey was taken to get quantitative data on CEO's perception on organizational accountability. To CEOs, accountability was very complex and unfamiliar concept, but understood as physician's code of ethics by nature and basic principle of hospital management. CEOs thought accountability could be improved through ethical leadership, financial stability and learning climate of hospitals. Distrust of the government, which failed to provide economic incentives for hospitals to increase accountability activities, was emphasized as a serious barrier to hospital accountability. There was consensus among hospital CEOs as to the importance of accountability in management. However, there were concerns that, without policy instruments to motivate hospitals toward increasing community benefits as well as collective efforts among health professionals to rebuild moral climate for being accountable, greater accountability would not be achieved in hospitals.

• 보건행정학회지
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• 제29권3호
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• pp.288-302
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• 2019

Background: The one-person households (OPH) are rapidly increasing and vulnerable to socioeconomic and health problems. Because it is predicted to be inequitable to health care utilization, we would like to find out about the equity of health care utilization of the OPH by comparison with the multi-person households (MPH). Methods: This study followed the theoretical framework of Wagstaff and van Doorslaer (2000), O'Donnell and his colleagues (2008), where the horizontal inequity index is the difference between the concentration indices of actual health care utilization and health care needs. This study employed the 9th Korea Health Panel survey, and a total of 10,807 cases were analyzed. Health care needs were measured by age, sex, subjective health status, chronic disease count, Charlson's Comorbidity Index, limitation of activities, and disability. Results: Compared with the MPH, there were pro-poor inequities in hospitalization, emergency utilization, hospitalization out-of-pocket payments, and pro-rich inequities in outpatient out-of-pocket payments for the OPH. The decomposition of the concentration index revealed that chronic disease count made the largest contribution to socioeconomic inequality in outpatient utilization. Age, health insurance, economic activities, and subjective health status also proved more important contributors to inequality. The variables contributing to the hospitalization and emergency utilization inequity were age, education, Charlson's Comorbidity Index, marital status, and income. Conclusion: Because the OPH was more vulnerable to health problems than the MPH and there were pro-poor inequities in medical utilization, hospitalization, and emergency costs, it is necessary to develop a policy that can correct and improve the portion of high contribution to medical utilization of the OPH.

• 보건행정학회지
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• 제31권3호
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• pp.261-271
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• 2021

Background: In 2018, the government increased the fee for the magnetic resonance imaging (MRI) image deciphering services of the external hospital to discourage the redundant MRI scan and to induce appropriate use of the MRI services. It is important to evaluate the effect of the policy to provide the basis for establishing other MRI-related policies. Methods: The healthcare data of the patients who had brain MRI scans were organized by episode and analyzed using the panel study in order to find out the effect of the MRI-related policy on the substitution effect and the medical expenses. Results: As a result of the increase in the fee of deciphering the MRI image, there has been an uplift in deciphering the MRI scan of the external hospital. It implies that more hospitals chose to use the MRI scan taken by other clinics or hospitals, rather than the MRI scan taken at their own facilities. Conclusion: The research results imply that a policy that facilitates the exchange of the medical image data between the hospitals is needed in order to establish an efficient management system of the healthcare resources. Such improvement is expected to reduce the social cost and contribute to the stability in the finance of national health insurance.

• 보건의료산업학회지
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• 제12권2호
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• pp.63-73
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• 2018

Objectives : This study aimed investigate general characteristics, vaccination status and health beliefs related to vaccination for herpes zoster and to identify variables. Methods : The structured questionnaire was conducted from March 31, 2016 to April 20, 2016 with 312 outpatients who visited a university hospital. The data were analyzed by frequency analysis, t-test, $x^2-test$, correlation analysis and logistic regression analysis via SPSS statistics 22.0. Results : The vaccination rate of the herpes zoster was 16.0% and the vaccination cost was the most common reason for rejecting inoculation. More highly educated people with more than a university degree(OR=4.28, p=.002), those with higher susceptibility to herpes zoster(OR=1.56, p=.000), those more aware of the benefits of vaccination(OR=1.51, p=.009) and those with lower disability for vaccination(OR=0.74, p=.003) were more likely to be vaccinated. Conclusions : Therefore, to increase the vaccination rate of herpes zoster in adults over 50 years old, continuous publicity and education are needed to emphasize the susceptibility of herpes zoster and the benefit of vaccination. In addition, it is necessary to develop policies at the national level for the expensive vaccination cost that obstructs vaccination.

• 보건행정학회지
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• 제31권2호
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• pp.173-179
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• 2021

Background: In Korea, the length of stay and medical expenses incurred by medical aid patients are increasing at a rate faster than the national health insurance. Therefore, there is a need to create a management strategy for each type of hospitalization to manage the length of stay of medical aid patients. Methods: The study used data from the 2019 National Health Insurance Claims. We analyzed the factors that affect the length of stay for 186,576 medical aid patients who were hospitalized for more than 31 days, with a focus on the type of hospitalization in long-term care hospitals. Results: The study found a significant correlation between gender, age, medical aid type, chronic disease ratio, long-term care hospital patient classification, and hospitalization type variables as factors that affect the length of hospital stay. The analysis of the differences in the length of stay for each type of hospitalization showed that the average length of stay is 291.4 days for type 1, 192.9 days for type 2, and 157.0 days for type 3, and that the difference is significant (p<0.0001). When type 3 was 0, type 1 significantly increased by 99.4 days, and type 2 by 36.6 days (p<0.0001). Conclusion: A model that can comprehensively view factors, such as provider factors and institutional factors, needs to be designed. In addition, to reduce long stays for medical aid patients, a mechanism to establish an early discharge plan should be prepared and concerns about underutilization should be simultaneously addressed.